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SAN J O A Q U I N Environmental Health Department Underground Storage Tank Program Inspection Report Facility Name: Facility Address: Date: Mossdale Chevron 444 W MOSSDALE RD LATHROP June 13 2019 Single-Walled Non-Pressurized Piping 401 CCR 2636(a)(3), Suction piping not properly sloped or incorrectly located check valve V R COS 2641(b) 402 CCR 2643(d) No monitoring or record maintenance for single-walled conventional suction systems(pre-Jan 1984). �V i-,R COS 403 CCR 2643(d),2661(f) Failure to conduct 0.1 gph test for single-walled conventional suction systems(pre-Jan 1984) ❑V ❑R ❑COS 404 CCR 2643(e), 2661(f) Biennial 0.1 gph line integrity test for single-walled gravity piping not performed(pre-Jan 1984) V R COS Other Violations 2010 1 See below Unlisted General violation V R COS SUMMARY OF VIOLATIONS (CLASS I,CLASS II,or MINOR-Notice to Comply) Item# Remarks 103 HSC 25292.2, 25299.30 Failure to submit and maintain complete and current financial responsibility documents. An approved copy of financial responsibility documents were not available for inspection. Financial documents on site are outdated. A copy of these documents shall be accessible on site at all times. Immediately locate and retain a copy on site. This is a minor violation. 104 CCR 2711 UST operating permit application for facility and tank information not submitted or current. The UST Tank Information forms for the 87, 91 and diesel tanks are not current in CERS. Tank manufacturer information is missing. Any change of information must be updated in CERS within 30 days of the changes. Immediately log into CERS, update the required information, and submit for review by the EHD. This is a Class II violation. 107 CCR 2632(d), 2641(h), 2711(a) Plot plan/site map not submitted or failed to completely show where monitoring is performed. An accurate UST Monitoring Site Plan was not submitted. A site plan must be submitted identifying the location of the annular space sensor. Immediately log into the California Environmental Reporting System (CERS) at http://cers.calepa.ca.gov/and upload a copy of the UST Monitoring Site Plan. This is a minor violation. 109 CCR 2637(a-d), 2712 Failed to test secondary containment, or failed to maintain test records for 36 months. According to the designated operator's monthly inspection reports and test results onsite, secondary containment testing was last performed on 3/27/2016 and was due by March 2019 . Testing has not been completed and is 3 months past due. Secondary containment testing is required once every 36 months. Immediately schedule this test and provide 48 hours notification to the EHD. This is a Class II violation. FA0000212 PR0231692 SCO01 06/13/2019 EHD 23-01 Rev.09/28/2018 Page 4 of 7 Underground Storage Tank Program OIR 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com